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幕上弥漫性胶质瘤的空间分布:990例回顾性研究。

Spatial distribution of supratentorial diffuse gliomas: A retrospective study of 990 cases.

作者信息

Li Gen, Yin Chuandong, Zhang Chuanhao, Xue Bowen, Yang Zuocheng, Li Zhenye, Pan Yuesong, Hou Zonggang, Hao Shuyu, Yu Lanbing, Ji Nan, Gao Zhixian, Deng Zhenghai, Xie Jian

机构信息

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

China National Clinical Research Center for Neurological Diseases, Beijing, China.

出版信息

Front Oncol. 2023 Jan 24;13:1098328. doi: 10.3389/fonc.2023.1098328. eCollection 2023.

Abstract

BACKGROUND

Gliomas distribute unevenly in the supratentorial brain space. Many factors were linked to tumor locations. This study aims to describe a more detailed distributing pattern of these tumors with age and pathological factors concerned.

METHODS

A consecutive series of 990 adult patients with newly-diagnosed supratentorial diffuse gliomas who underwent resection in Beijing Tiantan Hospital between January 2013 and January 2017 were retrospectively reviewed. For each patient, the anatomic locations were identified by the preoperative MRI, and the pathological subtypes were reviewed for histological grade and molecular status (if any) from his medical record. The MNI template was manually segmented to measure each anatomic location's volume, and its invaded ratio was then adjusted by the volume to calculate the frequency density. Factors of age and pathological subtypes were also compared among locations.

RESULTS

The insulae, hippocampi, and corpus callosum were locations of the densest frequencies. The frequency density decreased from the anterior to posterior (frontal - motor region - sensory region - parietal - occipital), while the grade (p < 0.0001) and the proportion of IDH-wt (p < 0.0001) increased. More tumors invading the right basal ganglion were MGMT-mt (p = 0.0007), and more of those invading the left frontal were TERT-wt (p = 0.0256). Age varied among locations and pathological subtypes.

CONCLUSIONS

This study demonstrated more detailed spatial disproportions of supratentorial gliomas. There are potential interactions among age, pathological subtypes, and tumor locations.

摘要

背景

胶质瘤在幕上脑区分布不均。许多因素与肿瘤位置有关。本研究旨在描述这些肿瘤在考虑年龄和病理因素时更详细的分布模式。

方法

回顾性分析2013年1月至2017年1月在北京天坛医院接受手术切除的990例新诊断幕上弥漫性胶质瘤成年患者。对于每位患者,通过术前MRI确定解剖位置,并从病历中复查病理亚型的组织学分级和分子状态(如有)。手动分割MNI模板以测量每个解剖位置的体积,然后通过体积调整其侵袭率以计算频率密度。还比较了各位置之间的年龄和病理亚型因素。

结果

岛叶、海马体和胼胝体是频率最高的部位。频率密度从前向后(额叶-运动区-感觉区-顶叶-枕叶)降低,而分级(p<0.0001)和异柠檬酸脱氢酶野生型(IDH-wt)比例(p<0.0001)增加。更多侵犯右侧基底节的肿瘤是O6-甲基鸟嘌呤-DNA甲基转移酶(MGMT)甲基化型(p=0.0007),更多侵犯左侧额叶的肿瘤是端粒酶逆转录酶(TERT)野生型(p=0.0256)。年龄在不同位置和病理亚型之间存在差异。

结论

本研究展示了幕上胶质瘤更详细的空间不均衡性。年龄、病理亚型和肿瘤位置之间存在潜在相互作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0ca/9904506/bf8af602a316/fonc-13-1098328-g001.jpg

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